The Swedish Approach to Management of Extreme Prematurity at the Borderline of Viability: A Historical and Ethical Perspective

Pediatrics
Magnus Domellöf, Baldvin Jonsson

Abstract

Sweden has a long tradition of being at the forefront of the management of extremely preterm infants. In this article, we explore the historical background, ethical discussions, and evidence from national surveys combined with data from quality registers that form the background of the current Swedish guidelines for the care of extremely preterm infants. The current Swedish national guidelines suggest providing active care for preterm infants from 23 weeks' gestation and considering active care from 22 weeks' gestation. The survival of infants in gestational weeks 22 and 23 has increased and now exceed 50% and 60%, respectively; importantly, the Swedish proactive approach to care at the border of viability has not resulted in an increased proportion of functional impairment among survivors.

References

Sep 1, 1989·Acta paediatrica Scandinavica·B HagbergR Zetterstrom
Mar 1, 1989·Acta paediatrica Scandinavica·N W SvenningsenL Hellström-Westas
Jun 6, 2009·JAMA : the Journal of the American Medical Association·UNKNOWN EXPRESS GroupMargareta Wennergren
Jun 5, 2013·Pediatrics·Nozomi IshiiUNKNOWN Neonatal Research Network, Japan
Sep 24, 2013·Acta Paediatrica·Fredrik SereniusUNKNOWN EXPRESS study group
Apr 22, 2015·Pediatrics·Fredrik SereniusUNKNOWN EXPRESS Study Group
Aug 2, 2016·JAMA Pediatrics·Fredrik SereniusUNKNOWN Extremely Preterm Infants in Sweden Study Group

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Citations

Mar 27, 2019·JAMA : the Journal of the American Medical Association·Matthew A Rysavy, Danielle E Y Ehret
Feb 17, 2021·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Rosemarie A BolandLex W Doyle
Feb 19, 2021·Frontiers in Pediatrics·L De ProostA A E Verhagen
Jul 27, 2021·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·Gonzalo Zeballos SarratoUNKNOWN en representación del Grupo de Reanimación Neonatal de la Sociedad Española de Neonatología (GRN-SENeo)

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